Jelesić Z, Kulauzov M, Kozoderović G
Institut za zastitu zdravlja, 21000 Novi Sad, Futoska 121.
Med Pregl. 2000 Nov-Dec;53(11-12):564-7.
Every year foodborne infections cause millions of illnesses but many of them go undiagnosed and unreported. The epidemiology of these illnesses is changing, new pathogens have emerged (Escherichia coli O157:H7, Cyclospora cayetanensis, Vibrio vulnificus). Salmonella spp. is the most common bacterial cause of acute enterocolitis with us. All over the world, as well as in our country the most often isolated serotype is Salmonella Enteritidis. A great problem in many countries is the multiresistant Salmonella Typhimurium, as well as other serotypes resistant to a great number of antimicrobial drugs (S. Hadar, S. Typhi). Clinical microbiologists are often asked to determine the relatedness of bacterial isolates. Recently, traditional methods of strain typing such as bacteriophage typing, resistotyping and serotyping, have been supplemented or replaced in many laboratories with newer molecular methods such as plasmid fingerprinting, ribotyping. PCR-based methods, etc. The goal of strain typing is to provide evidence that epidemiologically related isolates collected during an outbreak are also genetically related and thus represent the same strain.
In the laboratory for Enterobacteriaceae of the Institute of Public Health Novi Sad in the four year period (1995-1998) 3659 primary isolates of Salmonella spp. were isolated using standard bacteriological methods (cultural, biochemical and serological examination). For certain strain of Salmonella Enteritidis, S. Typhimurium and S. Hadar susceptibility to antimicrobial agents was tested by disc-diffusion test (Kirby-Bauer) and plasmid profiles were analyzed. Plasmid DNA was extracted by Birnboim and Doly alkaline lysis method and plasmid bands were separated by electrophoresis in agarose gel.
In the period of 1995-1998 the most common serotype isolated was Salmonella Enteritidis with 3017 (82.5%) of the total number of isolated Salmonellas; S. Typhimurium 203 (5.5%), S. Hadar 118 (3.2%). Plasmid profiles were tested in 10 S. Enteritidis isolates that originated from patients with sporadic cases of diarrhea. All investigated strains had one plasmid band with molecular weight of 38 MDa. All isolates were susceptible to all antibiotics tested. Ten isolates of S. Hadar originated from one outbreak from food samples and stools of patients with diarrheal disease and from the worker in the restaurant. All isolates were resistant to ampicillin and streptomycin, and plasmid profile analysis showed 5 plasmid bands with molecular weights of 13, 5.4, 4.2, 2.0 and 1.7 MDa. Chosen strains of S. Typhimurim were not epidemically related. Strains number 1, 3, 4, 5 were susceptible to all antibiotics tested, and had only one plasmid of 50 MDa, strain number 7 was resistant to streptomycin and had 2 plasmid bands of 50 and 1.7 MDa, other strains were multiresistant and had different plasmid profiles with 4-7 plasmid bands with molecular weights ranging from 50-1.4 MDa.
Plasmid profile analysis is not a sufficient method for examination of Salmonella Enteritidis which is the most common cause of enterocolitis with us. It is, however, a helpful method for proving epidemiological and clonal relatedness of Salmonella isolates that are resistant to antimicrobial agents and have a great number of plasmids (such as some strains of S. Typhimurim and S. Hadar).
食源性感染每年导致数百万起疾病,但其中许多未得到诊断和报告。这些疾病的流行病学正在发生变化,出现了新的病原体(大肠杆菌O157:H7、卡耶塔环孢子虫、创伤弧菌)。沙门氏菌属是我国急性小肠结肠炎最常见的细菌病因。在全世界以及我国,最常分离出的血清型是肠炎沙门氏菌。在许多国家,一个大问题是多重耐药的鼠伤寒沙门氏菌以及对大量抗菌药物耐药的其他血清型(哈达尔沙门氏菌、伤寒沙门氏菌)。临床微生物学家经常被要求确定细菌分离株之间的相关性。最近,许多实验室用较新的分子方法(如质粒指纹图谱、核糖体分型、基于聚合酶链反应的方法等)补充或取代了传统的菌株分型方法,如噬菌体分型、耐药分型和血清分型。菌株分型的目的是提供证据,证明在一次疫情中收集的流行病学相关分离株在基因上也相关,因此代表同一菌株。
在诺维萨德公共卫生研究所肠杆菌科实验室,在四年期间(1995 - 1998年),使用标准细菌学方法(培养、生化和血清学检查)分离出3659株沙门氏菌属的原始分离株。对于某些肠炎沙门氏菌、鼠伤寒沙门氏菌和哈达尔沙门氏菌菌株,通过纸片扩散法(Kirby - Bauer)测试其对抗菌药物的敏感性,并分析质粒图谱。采用Birnboim和Doly碱性裂解方法提取质粒DNA,通过琼脂糖凝胶电泳分离质粒条带。
在1995 - 1998年期间,分离出的最常见血清型是肠炎沙门氏菌,占分离出的沙门氏菌总数的3017株(82.5%);鼠伤寒沙门氏菌203株(5.5%),哈达尔沙门氏菌118株(3.2%)。对源自散发性腹泻患者的10株肠炎沙门氏菌分离株进行了质粒图谱测试。所有研究菌株都有一条分子量为38 MDa的质粒条带。所有分离株对所有测试抗生素均敏感。10株哈达尔沙门氏菌分离株源自一次疫情,来自食品样本、腹泻病患者的粪便以及餐厅工作人员。所有分离株对氨苄青霉素和链霉素耐药,质粒图谱分析显示有5条质粒条带,分子量分别为13、5.4、4.2、2.0和1.7 MDa。所选的鼠伤寒沙门氏菌菌株在流行病学上不相关。1、3、4、5号菌株对所有测试抗生素敏感,仅有一个50 MDa的质粒;7号菌株对链霉素耐药,有两条质粒条带,分别为50和1.7 MDa;其他菌株多重耐药,有不同的质粒图谱,有4 - 7条质粒条带,分子量范围为50 - 1.4 MDa。
质粒图谱分析对于检查我国最常见的小肠结肠炎病因肠炎沙门氏菌来说并非一种充分的方法。然而它对于证明对抗菌药物耐药且有大量质粒的沙门氏菌分离株(如某些鼠伤寒沙门氏菌和哈达尔沙门氏菌菌株)的流行病学和克隆相关性是一种有用的方法。